State leaders hear of insurance woes for rehab patients
“To stay silent means death,” said Judy Rosser, executive director of the Blair County Drug and Alcohol Program, in regard to the opioid epidemic that has been affecting state residents.
Secretary Gary Tennis, of the state Department of Drug and Alcohol Programs, and Lt. Gov. Mike Stack came to the Pennsylvania College of Technology Thursday to host a fifth public hearing to learn about the epidemic from local testimonies.
Dr. Kenneth Martz, special assistant to Tennis; William Stauffer, executive director of the Pennsylvania Recovery Organization Alliance; and Michele Denk, executive director of the Pennsylvania Association of County Drug and Alcohol Administration also were on the panel.
They and 12 others in the field have formed a task force that is touring the state to hear from community members to get a firsthand understanding of what is going on at the local level of recovery care.
Members from agencies across multiple counties shared their experiences helping people with addiction and the recurring problems in the health care system.
“We are not treating this like the epidemic it is,” Rosser said.
Barriers she and other people involved in recovery programs have experienced are issues with insurance companies, lack of state funding, stigma and the shortage of family support resources.
Dale Heffline, certified recovery specialist for Gaudenzia in Sunbury, gave a testimony from his own life about the death of his 25-year-old son, Jason, 18 years ago.
Silence fell as he described the scenario of receiving a phone call from his ex-wife that their son had overdosed and was admitted to the emergency room.
“I relented the day he left rehab only after 17 days because his insurance would not cover anymore time or treatment,” he said.
Neither he nor his ex-wife could afford to keep their son in treatment without the insurance assistance, Heffline said.
After five days in the hospital, they decided to “pull the plug,” he said.
“Maybe we should have more stricter guidelines and stronger enforcement for this not to happen again,” he said. “So there would be no question about money, just recovery.”
The issue that insurance companies will not provide coverage for more than a few days of drug and alcohol rehabilitation has been occurring across the local area.
Sarah Hawkins, White Deer Run assistant regional director, said patients do not get enough time in treatment the first time, so they end up coming back and paying more in the long run.
Often people will get seven to 10 days of rehabilitation because that is all insurance companies will pay, she said. Also the copays and high deductibles are not affordable.
“They receive a short length of stay because they haven’t done enough damage (to themselves) to get long-term stay,” she said.
It is like waiting for stage 4 cancer to start treating it aggressively, Stauffer said.
Emily Fitzgerald, Gaudenzia certified recovery specialist, agreed that a few days of treatment is not enough to make a significant impact.
She said she has noticed it is difficult for people to get transportation to the clinic and afford child care while they are there. Those who have criminal records have difficult time acquiring a job and a residence to rent as well.
Family support needs to be set in place as well, she said.
“No family is immune from the issue, my own included,” Stack said.
After attending five public hearings in different cities in the state, he has learned the nuts and bolts of the opioid epidemic, which will help him and the task force to make legislative recommendations.
Hearing about insurance companies denying so many people with the life-threatening illness, they may suggest putting in strong sanctions to require them to medically treat addiction, he said.